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Research Summary

Severity of Alcohol Problems Predicts Recurrence and Persistence of Alcohol Dependence

This prospective cohort study in the Netherlands enrolled patients with remitted alcohol dependence (AD) (n=253) and current AD (n=135) and followed them for 2 years to identify independent risk factors for AD recurrence and persistence.

  • Alcohol dependence recurred in 15% of those with remitted AD and persisted in 41% of those with current AD.
  • Past-year total score on the Alcohol Use Disorders Identification Test (AUDIT) at baseline was predictive of AD recurrence and persistence (odds ratio per 5-point increase, 3.6 and 2.1, respectively).
  • More severe depressive and anxiety symptoms predicted recurrent AD; however, the great majority of patients reported these symptoms.
  • Male gender and high educational attainment predicted persistence of AD.


Not surprisingly, greater severity of alcohol dependence correlated with less stable recovery. For clinicians who use the AUDIT, this study demonstrates the predictive validity of this screening tool for longer-term risk of recurrence. It also reinforces the importance of anxiety and depression, both exceedingly common in recovery, as harbingers of relapse. We know from other clinical studies that treatment of these co-occurring conditions can reduce recurrence of alcohol dependence. Peter D. Friedmann, MD, MPH


Boschloo L, Vogelzangs N, van den Brink W, et al. Predictors of the 2-year recurrence and persistence of alcohol dependence. Addiction. February 28, 2012 [Epub ahead of print]. doi:10.1111/j.1360-0443.2012.03860.x